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"slug": "i88_nespecificheskiy_limfadenit",
"lead": "воспаление лимфатических узлов, причиной которого является инфекция",
"description": "<p><span id=\"docs-internal-guid-bea401e1-7fff-e7dd-1f79-b01cba079e4d\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Неспецифический лимфаденит - это заболевание, которое проявляется увеличением и воспалением лимфатических желез.</span></span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В большинстве случаев воспаление лимфатических узлов возникает как следствие той или иной болезни организма. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причиной неспецифического являются патологические процессы, развивающиеся на фоне попадания в организм вирусов и инфекции. Пародонтиты, абсцессы, запущенные кариозные процессы, ангина, простудные заболевания, токсоплазмоз, очаги нагноения и даже аллергические реакции – «благоприятный» фон для возникновения неспецифического лимфаденита. Воспаление лимфоузлов под мышкой в большинстве случаев также относится к данному типу.</span></p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Возбудителями лимфаденита являются гноеродные микроорганизмы, проникающие в лимфатические узлы по лимфатическим сосудам из очагов острого или хронического гнойного воспаления (флегмоны, панариции и т.д), с током лимфы, крови или путём непосредственного контакта. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Инфекция поступает в регионарные лимфатические узлы с током лимфы, оттекающей из первичных гнойных очагов. Лимфаденит может возникнуть и без предшествующего лимфангита, причем первичный очаг бывает настолько ничтожен и так быстро заживает, что к моменту возникновения лимфаденита обнаружить место вхождения инфекции уже не всегда удается. В редких случаях возможно попадание инфекции в лимфатические узлы вместе с кровотоком. Лимфаденит иногда возникает и вследствие непосредственного перехода воспалительного процесса с тканей, окружающих узел.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагностика лимфаденита лица, шеи, подмышечных впадин проводится путем сбора анамнеза и совокупности клинических проявлений. Труднее разобраться с тяжелыми формами заболевания, на фоне которого уже возникли осложнения.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врачу необходимо определить первопричину, источник появления лимфаденита, подобрать соответствующее лечение.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Также для диагностики используют:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">пункцию;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">сдачу проб Манту и Пирке на туберкулезную палочку;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">рентген грудной клетки;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">пальпацию увеличенных лимфоузлов;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">КТ и МРТ пораженных сегментов.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Обычно к исследованию заболевания подключаются также инфекционисты, венерологи, фтизиатры. Специалисты могут назначить:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">общий анализ крови;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">анализ на ВИЧ;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">осмотр ЛОРа;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">УЗИ лимфоузлов и органов брюшной полости.</span></li>\r\n</ul>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лечение лимфаденита при его катаральной или гиперпластической форме проводится консервативными методами. Для этого подключают:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">соблюдение покоя пациента;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">терапию антибиотиками;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">УВЧ;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">электрофорез;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">гальванизацию;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">покой пораженного участка тела;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">прием витаминов.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Дополнительно применяют препараты и мази с хорошим противовоспалительным эффектом, работающие на местном уровне.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Особое внимание уделяется лечению лимфаденита антибиотиками. Перед этим необходимо провести тест на чувствительность микроорганизмов к разным видам антибиотиков. Выбирают те препараты, к которым особо чувствительны возбудители.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если речь идет о гнойном лимфадените, то потребуется вскрыть гнойники, удалить их содержимое и провести санацию пораженных участков.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При выявлении туберкулезной палочки пациента отправляют на лечение в условиях стационара. Это поможет постоянно наблюдать больного, контролировать его лечение и защитить других людей от потенциального заражения.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для лечения хронической формы болезни нужно найти и вылечить основную причину, по которой страдают лимфоузлы. Только это поможет полностью избавиться от недуга, и больше никогда не вспоминать о нем.</span></p>",
"prevention": "<p><span id=\"docs-internal-guid-0d2a2836-7fff-7685-e6f5-3c22d46e2a1d\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Профилактика лимфаденитов требует предупреждения микротравм, инфицирования ран и ссадин, потертостей кожи. Также необходимо своевременное лечение очагов инфекции (ангины, кариеса зубов), вскрытие гнойных образований (панацириев, фурункулов).</span></span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Клинические признаки заболевания зависят от формы и типа лимфаденита. Он бывает острый или хронический, региональный (поражение лимфоузлов одной анатомической группы) и генерализированный (вовлечение нескольких групп лимфоузлов), серозный, гнойный, гангренозный, геморрагический, флегмонозный.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В норме лимфатические узлы не пальпируются или прощупываются в виде эластических, не большого размера, не спаянных с соседними тканями и друг с другом образований, кожа над узлами нормального цвета, прощупывание безболезненно.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Самые частые признаки неспецифического лимфаденита:</span></p>\r\n<p> </p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Увеличение размеров пораженных лимфатических структур</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Появляются выраженные болезненные ощущения при пальпации пораженного участка и при движениях</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Воспаленные узлы спаиваются между собой и с соседними тканями в один плотный конгломерат</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Кожа над больными узлами краснеет, становится горячей на ощупь, блестит, выглядит натянутой</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Появляются симптомы интоксикации организма – лихорадка, слабость, головная боль, отсутствие аппетита, чувство разбитости, боль в мышцах</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Сопровождается признаками основного заболевания.</span></p>\r\n</li>\r\n</ul>",
"image": null,
"image_alt": null,
"standard_type": 0,
"danger": 1,
"published": 1,
"parent": null,
"block_rubric": 98,
"standards": []
},
{
"id": 6576,
"symptoms": [
{
"id": 2758,
"synonyms": [
{
"name": "лимфаденопатия"
},
{
"name": "увеличение лимфоузлов"
},
{
"name": "лимфоузел воспаление"
},
{
"name": "лимфоузлы набухли"
},
{
"name": "увеличились лимфоузлы"
}
],
"body_points": [
{
"x": 273,
"y": 1533,
"r": 100
},
{
"x": 654,
"y": 1510,
"r": 100
},
{
"x": -202,
"y": 2724,
"r": 100
},
{
"x": 1178,
"y": 2748,
"r": 100
},
{
"x": 273,
"y": 5081,
"r": 100
},
{
"x": 654,
"y": 5081,
"r": 100
}
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},
"code": "I95",
"name": "Гипотензия",
"icd_name": "Гипотензия",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
3
],
"periodicity": 1,
"slug": "i95_gipotenziya",
"lead": "низкий уровень артериального давления при показателях ниже, чем 90/60 это только результат измерения, но не болезнь и не является жизнеугрожающим состоянием ",
"description": "У лиц с пониженным артериальным давлением (артериальная гипотензия) также могут быть жалобы, причиняющие выраженный дискомфорт. В частности, гипотензия в некоторых случаях проявляется приступами головокружения, снижением внимания и повышенной утомляемостью. Пониженное артериальное давление может оказывать неблагоприятное влияние на умственную деятельность. У здоровых людей на фоне гипотензии возможно замедление реакции и угнетение способности к сосредоточению.",
"etiology": "<p>Постоянная <a href=\"/symptom/nizkoe_davlenie/\" title=\"Перейти на страницу симптома Низкое давление\">артериальная гипотензия</a> может носить характер наследственной. Так называемая эссенциальная гипотензия (первичная гипотензия) является наиболее распространенной формой снижения артериального давления. Первичная гипотензия встречается в основном у молодых женщин с пониженной массой тела, чаще в тех случаях, когда существует семейная предрасположенность. В настоящее время отсутствует четкое объяснение причины стойкой гипотензии. Так или иначе, предрасположенность к низкому уровню артериального давления может переходить из поколения в поколение. Например, гипотензия часто наблюдается в одной семье у матери и у дочери. Если жалобы, связанные с низким уровнем артериального давления, отсутствуют, то эссенциальная гипотензия не причинит вреда организму. Более того, гипотензия способна предупреждать развитие заболеваний, связанных с повышенным уровнем артериального давления. Для лиц с гипотензией характерен меньший риск формирования склероза кровеносных сосудов (артериосклероз), а также его последствий, таких как ишемическая болезнь сердца, инфаркт миокарда, инсульт и облитерирующий артериит.</p>\r\n<p>Вторичной гипотензией называется снижение артериального давления вследствие заболевания или действия лекарственного препарата.</p>\r\n<p>Причиной развития гипотензии могут быть следующие заболевания:</p>\r\n<ul>\r\n<li>Гипофункция щитовидной железы (гипотиреоз)</li>\r\n<li>Гипофункция коры надпочечников (болезнь Аддисона)</li>\r\n<li>Гипофункция гипофиза (недостаточность передней доли гипофиза)</li>\r\n<li>Патология сердца (например, сердечная недостаточность, нарушения сердечного ритма, перикардит)</li>\r\n<li>Длительный постельный режим</li>\r\n<li>Дефицит жидкости (гиповолемия)</li>\r\n<li>Дефицит соли (гипонатриемия)</li>\r\n</ul>",
"pathogenesis": "",
"diagnostics": "<p>Опасение должна вызывать не сама гипотензия, а причины низкого давления. Следует выявить истинные причины такого состояния и обратить на них пристальное внимание, чтобы не допустить развития серьезных заболеваний сердечно-сосудистой и нервной систем.</p>\r\n<p><a href=\"/symptom/nizkoe_davlenie/\" title=\"Перейти на страницу симптома Низкое давление\">Артериальная гипотензия</a> чаще всего является физиологическим состоянием организма и опасности не представляет. Наоборот, легче сказать, чем не опасна <a href=\"/symptom/nizkoe_davlenie/\" title=\"Перейти на страницу симптома Низкое давление\">гипотония</a>. Гипотоникам не страшна самая коварная болезнь современности, порождающая инфаркты и инсульты, – <a href=\"/symptom/vysokoe_davlenie/\" title=\"Перейти на страницу симптома Высокое давление\">гипертония</a>. При гипотонии кровеносные сосуды дольше остаются чистыми и им не страшен атеросклероз. По статистике, люди с хронической гипотонией живут значительно дольше гипертоников.</p>",
"treatment": "<p>В большинстве случаев медикаментозное лечение гипотонии не требуется. Самые распространенные причины низкого давления – неправильный образ жизни и стрессы. Физиологическую гипотонию лечить <a href=\"/symptom/erektilnaya_disfunkciya/\" title=\"Перейти на страницу симптома Эректильная дисфункция\">не стоит</a>, но о ней нужно обязательно помнить, чтобы не допускать скачков давления. Если беспокоит какой-то один симптом гипотензии, к примеру, <a href=\"/symptom/sonlivost/\" title=\"Перейти на страницу симптома Сонливость\">сонливость</a>, то, прежде всего, стоит наладить режим дня. Одного этого бывает достаточно, чтобы справиться с неприятным состоянием. Можно призвать на борьбу с гипотонией народную медицину.</p>",
"prevention": "<p><a href=\"/symptom/nizkoe_davlenie/\" title=\"Перейти на страницу симптома Низкое давление\">Гипотония</a>, если она не вызвана органическими нарушениями, прекрасно может быть скорректирована правильным образом жизни. Чтобы для лечения гипотензии не понадобились лекарства, следует:</p>\r\n<ol>\r\n<li>Соблюдать режим дня;</li>\r\n<li>Высыпаться (как правило, гипотоникам нужно большее количество сна, чем людям с нормальным давлением);</li>\r\n<li>Правильно питаться, обеспечивая себя всеми витаминами и минералами, а если это невозможно при обычном питании, стоит принимать витаминные комплексы;</li>\r\n<li>Пить достаточно воды;</li>\r\n<li>Чаще бывать на воздухе, желательно каждый день совершать прогулку не менее получаса;</li>\r\n<li>Заниматься спортом – даже минимальная физическая нагрузка творит чудеса, это не должен быть профессиональный спорт, конечно, достаточно утренней гимнастики, активных игр с детьми;</li>\r\n<li>Принимать водные процедуры – обливаться прохладной водой, плавать, закаливаться;</li>\r\n<li>Посещать баню или сауну, которые благотворно действуют на тонус сосудов;</li>\r\n<li>Сохранять хорошее настроение и не беспокоиться по пустякам.</li>\r\n</ol>\r\n<p>Это базовые рекомендации, которые необходимо соблюдать всем людям с разным уровнем давления, однако для гипотоников такая профилактика может полностью заменить лечение.</p>",
"clinical_picture": "<p>Кровяное давление – величина измеряемая, его можно определить при помощи тонометра. Если прибор показывает значения 90 мм ртутного столба систолического (так называемого верхнего) и 60 мм ртутного столба диастолического (нижнего) давления или ниже, то такое состояние можно назвать артериальной гипотензией или пониженным давлением.</p>\r\n<p>Помимо показаний тонометра существуют следующие симптомы гипотонии:</p>\r\n<ul>\r\n<li><a href=\"/symptom/slabost/\" title=\"Перейти на страницу симптома Слабость\">слабость</a>, <a href=\"/symptom/sonlivost/\" title=\"Перейти на страницу симптома Сонливость\">сонливость</a>;</li>\r\n<li><a href=\"/symptom/razdrazhitelnost_i_ozloblenie/\" title=\"Перейти на страницу симптома Раздражительность и озлобление\">раздражительность</a>;</li>\r\n<li>чувствительность к погодным изменениям;</li>\r\n<li>эмоциональная неустойчивость, <a href=\"/symptom/apatiya/\" title=\"Перейти на страницу симптома Апатия\">апатия</a>;</li>\r\n<li>рассеянность, ухудшение памяти;</li>\r\n<li><a href=\"/symptom/vyalost/\" title=\"Перейти на страницу симптома Вялость\">вялость</a> по утрам;</li>\r\n<li>повышенная <a href=\"/symptom/potlivost/\" title=\"Перейти на страницу симптома потливость\">потливость</a>;</li>\r\n<li>нарушение терморегуляции (холодные кисти и стопы);</li>\r\n<li>чувствительность к смене климатических условий;</li>\r\n<li><a href=\"/symptom/odyshka/\" title=\"Перейти на страницу симптома Одышка\">одышка</a> и сильное <a href=\"/symptom/narushenie_serdechnogo_ritma/\" title=\"Перейти на страницу симптома Нарушение сердечного ритма\">сердцебиение</a> при физических нагрузках;</li>\r\n<li>бледность;</li>\r\n<li><a href=\"/symptom/golovnaya_bol/\" title=\"Перейти на страницу симптома Головная боль\">головная боль</a>, обычно тупая, стягивающая, распирающая или пульсирующая чаще в лобно-височной или лобно-теменной области;</li>\r\n<li>головокружения;</li>\r\n<li>склонность к укачиванию, <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">тошнота</a>.</li>\r\n</ul>\r\n<p>Артериальная <a href=\"/symptom/nizkoe_davlenie/\" title=\"Перейти на страницу симптома Низкое давление\">гипотония</a> очень часто проявляется обмороками, особенно в душных помещениях. В целом, можно сказать, что люди с пониженным давлением негативно реагируют на малейшие изменения внешней среды – на изменение температуры воздуха, влажности, на духоту, а также на различные эмоциональные раздражители.</p>\r\n<p>Сами по себе перечисленные признаки не являются симптомами, точно подтверждающими наличие гипотензии. Единичные случаи слабости или головокружения не говорят о низком давлении. А вот если симптомов несколько и они постоянны, то стоит обратиться к доктору.</p>",
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"image_alt": "Низкое давление",
"standard_type": 3,
"danger": 1,
"published": 1,
"parent": null,
"block_rubric": 99,
"standards": []
},
{
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"etiology": "<p>Факторы, способствующие развитию алкогольной болезни печени:</p>\r\n<ul>\r\n<li>высокие дозы употребляемого алкоголя, частота и продолжительность его употребления;</li>\r\n<li>женский пол (активность алкогольдегидрогеназы у женщин, как правило, ниже);</li>\r\n<li>генетическая предрасположенность к развитию алкогольной болезни печени. Она проявляется различиями в активности ферментов (алкогольдегидрогеназы и ацетальдегиддегидрогеназы), которые участвуют в метаболизме алкоголя в организме, а также недостаточностью системы цитохрома P-450 2E1печени.;</li>\r\n<li>сопутствующие или перенесенные болезни печени;</li>\r\n</ul>\r\n<p>нарушения обмена веществ (метаболический синдром, ожирение, вредные пищевые привычки нарушение диеты), эндокринные расстройства.</p>",
"pathogenesis": "<p>Ключевую роль в поражении печени алкоголем играет этанол и его более токсичное производное – ацетальдегид. Можно выделить несколько механизмов поражения.</p>\r\n<p>Во-первых, алкоголь способствует повышенному образованию жирных кислот и уменьшает их окисление. Это приводит к накоплению избытка жира в клетках печени (гепатоцитах), то есть к развитию ее жировой дистрофии.</p>\r\n<p>Второй механизм поражения печени связан с окислением алкоголя ферментами, в частности алкогольдегидрогеназой. В результате в избытке образуются свободные кислородные радикалы (оксидативный стресс) и ацетальдегид, оказывающие повреждающее действие на ее клетки.</p>\r\n<p>Третий механизм обусловлен повышением проницаемости кишечной стенки под влиянием алкогольных напитков. Вследствие этого липополисахариды (продукты жизнедеятельности грамотрицательной флоры кишечника) через кровь проникают в печень, где стимулируют выработку клетками Купфера провоспалительных цитокинов – биологически активных веществ, вызывающих воспаление.</p>\r\n<p>Четвертый механизм связан с активацией свободными радикалами иммунной системы и иммуноопосредованным воспалением, и поражением печени.</p>\r\n<p>Следствием воспаления является разрушение гепатоцитов (цитолиз), их гибель (некроз) и разрастание соединительной ткани (фиброз). Прогрессирующий фиброз приводит к нарушению нормального долькового строения печени – циррозу, а в дальнейшем к первичному раку – гепатоцеллюлярной карциноме.</p>",
"diagnostics": "<p>В диагностике алкогольной болезни печени значительную роль играет сбор анамнеза и выявление продолжительного злоупотребления пациентом алкоголя. </p>\r\n<p>При лабораторных исследованиях в общем анализе крови отмечается макроцитоз (сказывается токсическое влияние алкоголя на костный мозг), лейкоцитоз, ускорение СОЭ. Может отмечаться мегабластическая (В12 или фолиеводефицитная) и железодефицитная анемия. Пониженное количество тромбоцитов связано с угнетением функций костного мозга, а также выявляется как симптомом гиперспленизма (увеличение селезенки) при повышении давления в системе полой вены при циррозе.</p>\r\n<p>При биохимическом исследовании крови отмечают повышение активности печеночных ферментов (АСТ и АЛТ). Также отмечают высокое содержание билирубина. Иммунологический анализ выявляет повышение уровня иммуноглобулина А. При употреблении алкоголя в среднесуточной дозе более 60 г чистого этанола в сыворотке крови отмечают повышение обедненного углеводами трансферрина. Иногда может отмечаться повышение количества сывороточного железа. Также у пациентов отмечается нарушение жирового обмена – в крови повышается содержание триглицеридов.</p>\r\n<p>К инструментальным методикам, помогающим диагностировать алкогольную болезнь, относят УЗИ органов брюшной полости и печени, доплерографию, КТ, МРТ печени, радионуклеиновое исследование и биопсию ткани печени.</p>\r\n<p>При проведении УЗИ печени хорошо видны признаки изменений размеров и формы, жирового перерождения печени (характерная гиперэхогенность тканей печени). Ультразвуковая доплерография выявляет портальную гипертензию и повышение давления в системе печеночной вены. Компьютерная и магнитно-резонансная томография хорошо визуализирует ткань печени и ее сосудистую систему. При радионуклеидном сканировании выявляются диффузные изменения в печеночных дольках. Для окончательного подтверждения алкогольной болезни проводят биопсию печени для гистологического анализа.</p>\r\n<p> </p>",
"treatment": "<p>Немедикаментозные методы лечения</p>\r\n<ul>\r\n<li>Отказ от алкоголя. Основным методом терапии алкогольной болезни печени является полный отказ от алкоголя. На любой стадии эта мера способствует благоприятному течению заболевания. Признаки стеатоза могут исчезать при воздержании от приема алкоголя в течение 2-4 недель.</li>\r\n</ul>\r\n<ul>\r\n<li>Диетотерапия. Важно придерживаться пищевого рациона, содержащего достаточные количества белка и калорий, так как у людей, злоупотребляющих алкоголем, часто развивается дефицит белков, витаминов и микроэлементов (особенно калия, магния и фосфора). </li>\r\n</ul>\r\n<p>Назначаются витамины (В 6 , В 12 , С, К, Е) в составе мультивитаминных препаратов.</p>\r\n<p>При анорексии применяется зондовое или парентеральное питание. </p>\r\n<p>Медикаментозные методы лечения</p>\r\n<ul>\r\n<li>Дезинтоксикационная терапия. Проведение дезинтоксикационных мероприятий необходимо при всех стадиях алкогольной болезни печени. Курс обычно составляет 5 дней.</li>\r\n<li>Кортикостероиды. Применение этих препаратов оправдано у пациентов с тяжелой формой острого алкогольного гепатита при отсутствии инфекционных осложнений и желудочно-кишечных кровотечений.</li>\r\n</ul>\r\n<ul>\r\n<li>Урсодеоксихолевая кислота - оказывает стабилизирующее действие на мембраны гепатоцитов: на фоне терапии отмечается улучшение лабораторных показателей (AсАТ, АлАТ, ГГТП, билирубина).</li>\r\n</ul>\r\n<ul>\r\n<li>Эссенциальные фосфолипиды. Механизм действия этих препаратов заключается в восстановлении структуры клеточных мембран, нормализации молекулярного транспорта, деления и дифференцировки клеток, стимуляции активности различных ферментных систем, антиоксидантных и антифибротических эффектах.</li>\r\n</ul>\r\n<ul>\r\n<li>Лечение контрактуры Дюпюитрена. Лечение заболевания на начальных стадиях может быть консервативным (физиотерапия); на поздних стадиях проводится хирургическое лечение.</li>\r\n</ul>\r\n<ul>\r\n<li>Лечение цирроза печени. При возникновении цирроза печени основная задача лечения заключается в профилактике и лечении его осложнений (кровотечений из варикозно-расширенных вен пищевода, асцита , печеночной энцефалопатии).</li>\r\n</ul>\r\n<ul>\r\n<li>Лечение осложнений алкогольной болезни печени. Осложнения диагностируются у пациентов с алкогольным гепатитом и циррозом печени и являются результатом развития портальной гипертензии . Лечение асцита , спонтанного бактериального перитонита, гепаторенального синдрома, печеночной энцефалопатиии кровотечений из варикозно-расширенных вен проводится медикаментозными и хирургическими методами. </li>\r\n</ul>\r\n<p>Хирургическое лечение</p>\r\n<p>Трансплантация печени выполняется пациентам, находящимся в терминальной стадии алкогольной болезни печени. Основным условием для выполнения трансплантации печени является не менее чем 6-месячная абстиненция от алкоголя. Операция позволяет добиться 5-летней выживаемости у 50% пациентов с острым алкогольным гепатитом.</p>\r\n<p> </p>",
"prevention": "<p>Профилактика алкогольная болезнь печени</p>\r\n<ul>\r\n<li>Отказ от приема алкоголя.</li>\r\n<li>Своевременное полноценное лечение всех стадий алкогольной болезни — снижает риск перехода в более тяжелую стадию и развития осложнений.</li>\r\n<li>Рациональное и сбалансированное питание (отказ от слишком горячей, копченой, жареной и консервированной пищи).</li>\r\n</ul>",
"clinical_picture": "<p>Заболевание развивается постепенно и незаметно для больного. Проходит обычно около пяти лет с момента возникновения повреждения печени до появления первых симптомов. По мере ухудшения состояния печени нарастает количество и выраженность симптомов. Все проявления алкогольной болезни печени представлены несколькими синдромами (устойчивая совокупность симптомов, объединенных единым развитием).</p>\r\n<p>Астенический синдром:</p>\r\n<ul>\r\n<li>повышенная утомляемость;</li>\r\n<li>слабость;</li>\r\n<li>сонливость днем;</li>\r\n<li>снижение аппетита;</li>\r\n<li>подавленное настроение.</li>\r\n</ul>\r\n<p>Диспептические проявления (расстройства пищеварения):</p>\r\n<ul>\r\n<li>снижение аппетита;</li>\r\n<li>тошнота и рвота;</li>\r\n<li>вздутие живота;</li>\r\n<li>боль в околопупочной области;</li>\r\n<li>урчание в животе.</li>\r\n</ul>\r\n<p>Системные проявления алкогольной интоксикации(влияния алкоголя на различные органы):</p>\r\n<ul>\r\n<li>Периферическая полинейропатия (повреждение нервов, соединяющих органы и конечности человека с головным и спинным мозгом). Проявляется нарушениями чувствительности и ограничением движений;</li>\r\n<li>Мышечная атрофия (слабость в мышцах конечностей за счет их истончения и уменьшения объема);</li>\r\n<li>Тахикардия (учащенное сердцебиение) и одышка (учащенное дыхание) вследствие поражения сердечно-сосудистой системы.</li>\r\n<li>Кахексия(истощение), снижение массы тела.</li>\r\n<li>Артериальная гипотония— снижение систолического (первая цифра при измерении) артериального давления ниже 100 миллиметров ртутного столба.</li>\r\n<li>Синдром «малых» печеночных признаков (синдром печеночно-клеточной недостаточности):</li>\r\n</ul>\r\n<p>Ø Телеангиоэктазии (сосудистые «звездочки» на лице и теле).<br />Ø Покраснение кожи ладоней и стоп;<br />Ø У мужчин наблюдается отложение жира на бедрах и на животе, тонкие конечности; скудное оволосение в подмышечной области и на лобке; гинекомастия (образование и увеличение молочных желез у мужчины); атрофия яичек (уменьшение объема ткани яичек, расстройство их функции); импотенция (расстройство половой и эректильной функции у мужчин, невозможность совершить нормальный половой акт).<strong> </strong></p>\r\n<ul>\r\n<li>Гипертрофия (увеличение) околоушных слюнных желез.</li>\r\n<li>Расширенная капиллярная сеть на лице (красное лицо).</li>\r\n<li>Склонность к образованию «синяков».</li>\r\n<li>Контрактура Дюпюитрена (безболезненный подкожный тяж – уплотнение тканей в виде жгута) — искривление и укорочение сухожилий ладони, приводящее к ограничению функции ладони и ее сгибательной деформации.</li>\r\n<li>Желтушная окраска кожи, слизистых оболочек полости рта и склер (белых оболочек глазного яблока).</li>\r\n<li>Лейконихии (мелкие белые полоски на ногтях).</li>\r\n<li>Симптомы « барабанных палочек» (увеличение размеров кончиков пальцев рук, отчего их внешний вид похож на барабанные палочки) и « часовых стекол» (увеличение размеров и округлое изменение ногтевых пластин).</li>\r\n<li>Синдром портальной гипертензии(повышения давления в системе воротной вены – сосуда, приносящего кровь в печень от органов брюшной полости):\r\n<ul>\r\n<li>увеличение селезенки;</li>\r\n<li>асцит (свободная жидкость в брюшной полости);</li>\r\n<li>варикозное (деформационное) расширение вен пищевода (несущих кровь от пищевода к сердцу);</li>\r\n<li>расширение параумбиликальных (находящихся в области пупка) вен – симптом « головы медузы» (характерный венозный рисунок на животе в виде расходящихся в разные от пупка стороны синих вен);</li>\r\n<li>варикозное расширение верхних прямокишечных вен (выносящих кровь от верхней части прямой кишки).</li>\r\n</ul>\r\n</li>\r\n</ul>\r\n<p>Состояние пациента значительно улучшается после прекращения приема алкоголя. Периоды резкого ухудшения состояния связаны с продолжающимся употреблением алкоголя, приводящим к развитию эпизодов острого алкогольного гепатита (воспаления печени).</p>\r\n<p> </p>",
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